Context Calorie restriction plus dietary advice is suggested as a preventive strategy for individuals with obesity and prediabetes, however, optimal diet is still debatable. We aimed to compare the effects of Mediterranean diet (MD) and Chinese diets high or low in plants on body weight and glucose homeostasis among high risk Chinese. Subjects and Methods In this parallel-arm randomized controlled trial, 253 Chinese adults aged 25-60 years with BMI ≥24.0 kg/m 2 and fasting blood glucose ≥5.6 mmol/L were randomly assigned to three isocaloric-restricted diets: MD (n = 84), a traditional Jiangnan Diet high in plants (TJD, n = 85), or a control diet low in plants (CD, n = 84). During the 6-month trial, a 5-weekday full feeding regimen was followed, along with mobile app-based monitoring. Abdominal fat measurement (magnetic resonance imaging), oral glucose tolerance test (OGTT), and continuous glucose monitoring (CGM) were conducted at baseline, 3- and 6-month. Results With a 25% calorie-restriction for 6 months, weight deduction was 5.72 kg (95% CI: 5.03, 6.40) for MD, 5.05 kg (4.38, 5.73) for TJD and 5.38 kg (4.70, 6.06) for CD (Ptime < 0.0001). No between-group differences were found for fasting glucose, insulin, and the Matsuda index from OGTT. Notably, CD had significantly longer time below range (glucose < 3.9 mmol/L) than MD [0.81% ( 0.21, 1.40), P = 0.024] and marginally longer time than TJD [0.56% (-0.03,1.15), P = 0.065], as measured by CGM. Conclusions With the 6-month isocaloric-restricted feeding, TJD and MD achieved comparable weight deduction and improved glucose homeostasis, whereas CD showed a higher risk for hypoglycemia.

Background: Omics data may provide a unique opportunity to discover dairy-related biomarkers and their linked cardiovascular health. Methods: Dairy-related lipidomic signatures were discovered in baseline data from a Chinese cohort study (n=2140) and replicated in another Chinese study (n=212). Dairy intake was estimated by a validated food-frequency questionnaire. Lipidomics was profiled by high-coverage liquid chromatography-tandem mass spectrometry. Associations of dairy-related lipids with 6-year changes in cardiovascular risk factors were examined in the discovery cohort, and their causalities were analyzed by 2-sample Mendelian randomization using available genome-wide summary data. Results: Of 350 lipid metabolites, 4 sphingomyelins, namely sphingomyelin (OH) C32:2, sphingomyelin C32:1, sphingomyelin (2OH) C30:2, and sphingomyelin (OH) C38:2, were identified and replicated to be positively associated with total dairy consumption (β=0.130 to 0.148; P <1.43×10 −4 ), but not or weakly with nondairy food items. The score of 4 sphingomyelins showed inverse associations with 6-year changes in systolic (−2.68 [95% CI, −4.92 to −0.43]; P =0.019), diastolic blood pressures (−1.86 [95% CI, −3.12 to −0.61]; P =0.004), and fasting glucose (−0.25 [95% CI, −0.41 to −0.08]; P =0.003). Mendelian randomization analyses further revealed that genetically inferred sphingomyelin (OH) C32:2 was inversely associated with systolic (−0.57 [95% CI, −0.85 to −0.28]; P =9.16×10 −5 ) and diastolic blood pressures (−0.39 [95% CI, −0.59 to −0.20]; P =7.09×10 −5 ). Conclusions: The beneficial effects of dairy products on cardiovascular health might be mediated through specific sphingomyelins among Chinese with overall low dairy consumption.

Background Few studies have assessed the integrative effects of diet, BMI, and exercise on postprandial changes of energy and circulating metabolic profiles. Objectives We aimed to assess the collective effects of three isocaloric diets high in carbohydrate (74.2% energy), fat (64.6% energy), or protein (39.5% energy) on energy expenditure, clinical and metabolomic biomarkers under resting and exercise conditions in normal-weight and overweight/obese men. Methods This cross-over controlled acute trial included 20 normal-weight (BMI: 18.5– &lt;24) and 20 overweight/obese (BMI ≥ 24 kg/m2) men aged 18–45 years. Each of three test meals was provided for two continuous days: “Resting Day” without exercise, followed by “Exercise Day” with a bicycling exercise of 50% maximal oxygen consumption (postprandial 90–120 min). Energy expenditure (exploratory outcome of primary interest) was measured using indirect calorimetry. Fasting and postprandial 2-hour serum clinical and metabolomic biomarkers (secondary interest) were measured. Mixed models were used to examine the effects of diet, time, and/or BMI category. Results On Resting Day, no significant between-meal differences were detected for energy expenditure. However, high-carbohydrate and high-fat meals induced the highest postprandial 2-hour increase in glucose (0.34 ± 0.15 mmol/L) and triglyceride (0.95 ± 0.09 mmol/L) respectively, while high-protein meal reduced glucose (-0.48 ± 0.08 mmol/L) and total cholesterol (-0.01 ± 0.03 mmol/L, all Pdiet &lt; 0.001). On Exercise Day, high-carbohydrate diet significantly promoted carbohydrate oxidation rate but suppressed fat oxidation rate (Pdiet &lt; 0.05), while its postprandial glucose response was attenuated by bicycling (-0.31 ± 0.03 mmol/L, Pexercise &lt; 0.001). 69 metabolites were identified as key features in discriminating the three meals, and overweight/obese men had more varieties of metabolites than normal-weight men. Conclusions Three isocaloric meals induced unique postprandial changes in clinical and metabolomic biomarkers, while exercise prevented high-carbohydrate meal induced hyperglycemia. Overweight/obese men were more responsive to the meal challenges than normal-weight men. This trial was registered at clinicaltrials.gov as NCT03231618.